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Multicenter Study
. 2021 Nov;11(11):e297-e316.
doi: 10.1542/hpeds.2021-006087. Epub 2021 Jun 24.

The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19

Sandeep Tripathi  1 , Amy L Christison  2 , Emily Levy  3 , Jeremy McGravery  4 , Aysun Tekin  3 , Dawn Bolliger  4 , Vishakha K Kumar  5 , Vikas Bansal  3 , Kathleen Chiotos  6 , Katja M Gist  7 , Heda R Dapul  8 , Utpal S Bhalala  9 , Varsha P Gharpure  10 , Julia A Heneghan  11 , Neha Gupta  12 , Erica C Bjornstad  13 , Vicki L Montgomery  14 , Allan Walkey  15 , Rahul Kashyap  3 , Grace M Arteaga; Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
Collaborators, Affiliations
Multicenter Study

The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19

Sandeep Tripathi et al. Hosp Pediatr. 2021 Nov.

Abstract

Objective: To describe the impact of obesity on disease severity and outcomes of coronavirus disease 2019 (COVID-19) among hospitalized children.

Methods: This retrospective cohort study from the Society of Critical Care Medicine Viral Respiratory Illness Universal Study registry included all children hospitalized with COVID-19 from March 2020 to January 2021. Obesity was defined by Centers for Disease Control and Prevention BMI or World Health Organization weight for length criteria. Critical illness definition was adapted from National Institutes of Health criteria of critical COVID. Multivariate mixed logistic and linear regression was performed to calculate the adjusted odds ratio of critical illness and the adjusted impact of obesity on hospital length of stay.

Results: Data from 795 patients (96.4% United States) from 45 sites were analyzed, including 251 (31.5%) with obesity and 544 (68.5%) without. A higher proportion of patients with obesity were adolescents, of Hispanic ethnicity, and had other comorbidities. Those with obesity were also more likely to be diagnosed with multisystem inflammatory syndrome in children (35.7% vs 28.1%, P = .04) and had higher ICU admission rates (57% vs 44%, P < .01) with more critical illness (30.3% vs 18.3%, P < .01). Obesity had more impact on acute COVID-19 severity than on multisystem inflammatory syndrome in children presentation. The adjusted odds ratio for critical illness with obesity was 3.11 (95% confidence interval: 1.8-5.3). Patients with obesity had longer adjusted length of stay (exponentiated parameter estimate 1.3; 95% confidence interval: 1.1-1.5) compared with patients without obesity but did not have increased mortality risk due to COVID-19 (2.4% vs 1.5%, P = .38).

Conclusion: In a large, multicenter cohort, a high proportion of hospitalized children from COVID-19 had obesity as comorbidity. Furthermore, obesity had a significant independent association with critical illness.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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